Monitoring metabolic health in the adolescent population of Rarotonga: a multi-year cross-sectional study from 2016 to 2023.
4 affiliations
- 1Liggins Institute, Waipapa Taumata Rau, University of Auckland, Private Bag 92109, Victoria Street West, Auckland, 1142, New Zealand. [email protected].
- 2Te Marae Ora, Cook Islands Ministry of Health, Rarotonga, Cook Islands.
- 3Liggins Institute, Waipapa Taumata Rau, University of Auckland, Private Bag 92109, Victoria Street West, Auckland, 1142, New Zealand.
- 4Maraurau o te Pae Api'i, Cook Islands Ministry of Education, Rarotonga, Cook Islands.
Abstract
Background
The Cook Islands, a small Pacific nation, carries a high burden of obesity (75%) and non-communicable disease (NCD) among adults. Primary prevention before adulthood, including school-based strategies, is a priority. Local evidence is crucial but challenging in resource-limited, low-population settings. This study presents data on the prevalence of risk factors associated with metabolic syndrome (MetS) among adolescents in Rarotonga, the main island of the Cook Islands.Methods
A multi-year cross-sectional survey of NCD risk factors in Year 9 students (median age: 13.8 years) between 2016-2019 and 2022-2023 (n = 783) represented 65% of the cohort (n = 1214). Data analysis used descriptive statistics with 5% significance testing.Results
The prevalence of risk factors include: 22.1% overweight, 37.6% obese; 39.1% Waist-to-Height ratio (WtHR) > 0.5 (study years: χ² p < 0.001); 9.4% high Blood Pressure (BP) (gender: χ² p < 0.001, study years: χ² p = 0.005); 8.1% elevated Total blood Cholesterol (TC) (study years: χ² p = 0.003); 37.1% elevated fasting Blood Sugar Levels (fBSL) (study years: χ² p = 0.007). Where all measures were available (n = 261), 27.6% of participants were living with obesity and ≥ 2 risk factors. Body-Mass-Index-for-Age (BMI-for-age) percentile and WtHR risk category proportions were positively correlated (χ² p < 0.001) with 78.9% of those with obesity falling into the increased risk WtHR category. Significant associations (all p < 0.001) were identified between elevated BP and BMI-for-age categories, WtHR, and TC levels.Conclusions
The multi-year cross-sectional approach enabled valid data within a low-resource setting that confirmed extremely high levels of overweight and obesity in the Year 9 student population. We argue that including waist circumference measures alongside BMI-for-age was a first step to enabling greater depth of understanding of the risk levels in this population. Some risk factors associated with MetS have been assessed, but investment in improving glucose and lipid monitoring is strongly recommended. This study highlights the importance of monitoring paediatric MetS in the Cook Islands. It suggests that it should be used longitudinally to inform the impact of interventions from early life through to adolescence.
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BibTeX
@article{bay2026monitoring,
title = {{Monitoring metabolic health in the adolescent population of Rarotonga: a multi-year cross-sectional study from 2016 to 2023.}},
author = {Jacquie L Bay and Tania John and Amy Renelle and Karen Ngamata and Celeste Barrett-Watson and Suzanne A Trask and Mark H Vickers and Danielle Tungane Cochrane and Metua Bates},
journal = {BMC public health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28637-x},
url = {https://europepmc.org/article/MED/42897504},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Monitoring metabolic health in the adolescent population of Rarotonga: a multi-year cross-sectional study from 2016 to 2023.
AU - Jacquie L Bay
AU - Tania John
AU - Amy Renelle
AU - Karen Ngamata
AU - Celeste Barrett-Watson
AU - Suzanne A Trask
AU - Mark H Vickers
AU - Danielle Tungane Cochrane
AU - Metua Bates
PY - 2026
DA - 2026/07/01
JO - BMC public health
DO - 10.1186/s12889-026-28637-x
UR - https://europepmc.org/article/MED/42897504
AB - Background The Cook Islands, a small Pacific nation, carries a high burden of obesity (75%) and non-communicable disease (NCD) among adults. Primary prevention before adulthood, including school-based strategies, is a priority. Local evidence is crucial but challenging in resource-limited, low-population settings. This study presents data on the prevalence of risk factors associated with metabolic syndrome (MetS) among adolescents in Rarotonga, the main island of the Cook Islands.Methods A multi-year cross-sectional survey of NCD risk factors in Year 9 students (median age: 13.8 years) between 2016-2019 and 2022-2023 (n = 783) represented 65% of the cohort (n = 1214). Data analysis used descriptive statistics with 5% significance testing.Results The prevalence of risk factors include: 22.1% overweight, 37.6% obese; 39.1% Waist-to-Height ratio (WtHR) > 0.5 (study years: χ² p < 0.001); 9.4% high Blood Pressure (BP) (gender: χ² p < 0.001, study years: χ² p = 0.005); 8.1% elevated Total blood Cholesterol (TC) (study years: χ² p = 0.003); 37.1% elevated fasting Blood Sugar Levels (fBSL) (study years: χ² p = 0.007). Where all measures were available (n = 261), 27.6% of participants were living with obesity and ≥ 2 risk factors. Body-Mass-Index-for-Age (BMI-for-age) percentile and WtHR risk category proportions were positively correlated (χ² p < 0.001) with 78.9% of those with obesity falling into the increased risk WtHR category. Significant associations (all p < 0.001) were identified between elevated BP and BMI-for-age categories, WtHR, and TC levels.Conclusions The multi-year cross-sectional approach enabled valid data within a low-resource setting that confirmed extremely high levels of overweight and obesity in the Year 9 student population. We argue that including waist circumference measures alongside BMI-for-age was a first step to enabling greater depth of understanding of the risk levels in this population. Some risk factors associated with MetS have been assessed, but investment in improving glucose and lipid monitoring is strongly recommended. This study highlights the importance of monitoring paediatric MetS in the Cook Islands. It suggests that it should be used longitudinally to inform the impact of interventions from early life through to adolescence.
SN - 1471-2458
ER -